The Association between Depression, Perceived Health Status, and Quality of Life among Individuals with Chronic Kidney Disease: An Analysis of the National Health and Nutrition Examination Survey 2011-2012

Background: Depression is the most common mental health disorder among those with end-stage renal disease (ESRD), with prevalence of 15-40%. However, the association between chronic kidney disease (CKD) and depression is more variable. We examined the associations of CKD with depression, perceived health status, and quality of life in the National Health and Nutrition Examination Survey (NHANES) 2011-2012. Methods: This study included 4,075 adults. Depression was defined as a condition when a Patient Health Questionnaire score was ≥10, or when there was reported antidepressant use. Reduced quality of life was defined by the number of days having poor mental and physical health, or feeling anxious. We calculated ORs for associations between CKD and depression and self-perceived health status, and used linear regression to examine associations between CKD and the number of days of poor health or anxiety. Results: The prevalence of CKD was 7.0% and that of depression was 19.1%. Those with CKD were not more likely to be depressed versus those without CKD after multivariate adjustment. Although they were 2.2 times more likely to have fair/poor health status after adjusting for demographic characteristics, this was attenuated by adjustment for confounders. Those with CKD reported one more day of being inactive due to poor health in the past month (p < 0.05), after multivariate adjustment. No differences were found for self-reported anxiety. Conclusion: Our findings suggest that NHANES participants with CKD have more days of poor health but are not more likely to be depressed or anxious. This may reflect differences between clinical CKD populations and community-based samples.